Assessing and addressing practitioner burnout: Results from an advanced practice registered nurse health and well-being study.
Journal
Journal of the American Association of Nurse Practitioners
ISSN: 2327-6924
Titre abrégé: J Am Assoc Nurse Pract
Pays: United States
ID NLM: 101600770
Informations de publication
Date de publication:
05 Nov 2019
05 Nov 2019
Historique:
received:
09
04
2019
accepted:
08
08
2019
pubmed:
9
11
2019
medline:
28
7
2021
entrez:
9
11
2019
Statut:
epublish
Résumé
Numerous nursing and physician studies have reported the effects of workload, environment, and life circumstances contributing to burnout. Effects may include job dissatisfaction, poor quality of life, and associated negative patient outcomes. Although assessing clinician burnout to determine effective interventions has become a topic of great importance, there are minimal studies specific to advanced practice registered nurses (APRNs). This single-center study was conducted to assess the prevalence and impact of APRN burnout and to recommend targeted interventions toward improvement of overall health and well-being. A cross-sectional, mixed methods design was used. The voluntary, anonymous survey examined perceptions of wellness, inclusion, social support, personal coping mechanisms, and status of burnout. The 78-question survey was sent to 1,014 APRNs (94%) and PAs (6%), with a 43.6% response rate (n = 433); 76.4% were nurse practitioners. Participants were identified as currently experiencing burnout, formerly burned out, or never having experienced burnout. Profiles were developed, and similarities and differences between each group were compared. Of 433 respondents, 40.4% (n = 175) reported having never experienced burnout, 33.3% (n = 144) reported they had formerly experienced burnout, and 26.3% (n = 114) reported they were currently experiencing burnout. The results of the study identified that some APRNs report experiencing burnout at different times in their careers. Recommendations by participants to mitigate burnout included self-care, organizational promotion of health and well-being, career development, and leadership support. This study is one of the first to report on burnout among APRNs and potential interventions to build resilience; however, additional research is warranted.
Sections du résumé
BACKGROUND
BACKGROUND
Numerous nursing and physician studies have reported the effects of workload, environment, and life circumstances contributing to burnout. Effects may include job dissatisfaction, poor quality of life, and associated negative patient outcomes. Although assessing clinician burnout to determine effective interventions has become a topic of great importance, there are minimal studies specific to advanced practice registered nurses (APRNs).
PURPOSE
OBJECTIVE
This single-center study was conducted to assess the prevalence and impact of APRN burnout and to recommend targeted interventions toward improvement of overall health and well-being.
METHODS
METHODS
A cross-sectional, mixed methods design was used. The voluntary, anonymous survey examined perceptions of wellness, inclusion, social support, personal coping mechanisms, and status of burnout.
RESULTS
RESULTS
The 78-question survey was sent to 1,014 APRNs (94%) and PAs (6%), with a 43.6% response rate (n = 433); 76.4% were nurse practitioners. Participants were identified as currently experiencing burnout, formerly burned out, or never having experienced burnout. Profiles were developed, and similarities and differences between each group were compared. Of 433 respondents, 40.4% (n = 175) reported having never experienced burnout, 33.3% (n = 144) reported they had formerly experienced burnout, and 26.3% (n = 114) reported they were currently experiencing burnout.
IMPLICATIONS FOR PRACTICE
CONCLUSIONS
The results of the study identified that some APRNs report experiencing burnout at different times in their careers. Recommendations by participants to mitigate burnout included self-care, organizational promotion of health and well-being, career development, and leadership support. This study is one of the first to report on burnout among APRNs and potential interventions to build resilience; however, additional research is warranted.
Identifiants
pubmed: 31702604
pii: 01741002-202101000-00007
doi: 10.1097/JXX.0000000000000324
doi:
Types de publication
Journal Article
Langues
eng
Pagination
38-48Informations de copyright
Copyright © 2019 American Association of Nurse Practitioners.
Déclaration de conflit d'intérêts
Competing interests: The authors report no conflicts of interest.
Références
American Academy of Physician Assistants. (2018). AAPA Salary Report. Retrieved from https://www.aapa.org/shop/salary-report/ .
American Association of Nurse Practitioners. (2018). NP Fact Sheet. Retrieved from https://www.aanp.org/about/all-about-nps/np-fact-sheet .
Card E., Hyman S. (2015). Prevalence and risk factors for burnout in the perianesthesia setting. Journal of PeriAnesthesia Nursing, 30, e40–e41.
Cimiotti J.P., Aiken L.H., Sloane D.M., Wu E.S. (2012). Nurse staffing, burnout, and health care-associated infection. American Journal of Infection Control, 40, 486–490.
Chen H., Chiang R. H., Storey V.C. (2012). Business intelligence and analytics: From big data to big impact. MIS Quarterly , 36, 1165–1188.
Chittenden E.H., Ritchie C.S. (2011). Work-life balancing: Challenges and strategies. Journal of Palliative Medicine, 14, 870–874.
Dell'Erba G., Venturi P., Rizzo F., Porcù S., Pancheri P. (1994). Burnout and health status in Italian air traffic controllers. Aviation, Space, and Environmental Medicine , 65, 312–322.
Dyrbye L., Shanafelt T., Sinsky C. (2017). Burnout among health care professionals: a call to explore and address this underrecognized threat to safe, high-quality care. NAM Perspectives. Discussion paper. Washington, DC: National Academy of Medicine. Retrieved from https://nam.edu/burnout-among-health-care-professionals-a-call-to-explore-and-address-this-underrecognized-threat-to-safe-high-quality-care/ .
Embriaco N., Azoulay E., Barrau K., Kentish N., Pochard F., Loundou A., Papazian L. (2007). High level of burnout in intensivists: Prevalence and associated factors. American Journal of Respiratory and Critical Care Medicine, 175 , 686–692.
Fritz C., Sonnentag S. (2006). Recovery, well-being, and performance-related outcomes: The role of workload and vacation experiences. The Journal of Applied Psychology, 91, 936–945.
Gabbe S.G., Melville J., Mandel L., Walker E. (2002). Burnout in chairs of obstetrics and gynecology: Diagnosis, treatment, and prevention. American Journal of Obstetrics & Gynecology MFM, 186 , 601–612.
Gillespie B. M., Chaboyer W., Wallis M., Grimbeck P. (2007). Resilience in the operating room: Developing and testing of a resilience model. International Journal of Advanced Nursing Studies, 59, 427–438.
Guo Y.F., Luo Y.H., Lam L., Cross W., Plummer V., Zhang J.P. (2018). Burnout and its association with resilience in nurses: A cross‐sectional study. International Journal of Nursing & Clinical practices, 27 , 441–449.
Gustafsson G., Strandberg G., Norberg A. (2010). Burnout and perceptions of conscience among health care personnel: A pilot study. Nursing Ethics, 17, 23–38.
Harris P. A., Taylor R., Thielke R., Payne J., Gonzalez N., Conde J. G. (2009). Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42, 377–381.
Hart P. L., Brannan J. D., De Chesnay M. (2014). Resilience in nurses: An integrative review. Journal of Nursing Management, 22, 720–734.
Hoff T., Carabetta S., Collinson G. (2017). Satisfaction, burnout, and turnover among nurse practitioners and physician assistants: A review of the empirical literature. Medical Care Research and Review, 76, 3–31.
Hooker R., Kuilman L., Everett C. (2015). Physician assistant job satisfaction: A narrative review of the empirical research. The Journal of Physician Assistant Education, 25, 176–186.
Hyman S. A., Michaels D. R., Berry J. M., Schildcrout J. S., Mercaldo N. D., Weinger M. B. (2011). Risk of burnout in perioperative clinicians: A survey study and literature review. Anesthesiology, 114, 194–204.
Hyman S. A., Shotwell M. S., Michaels D. R., Han X., Card E. B., Morse J. L., Weinger M. B. (2017). A survey evaluating burnout, health status, depression, reported alcohol and substance use, and social support of anesthesiologists. Anesthesia and Analgesia, 125, 2009–2018.
Kapu A. N., Kleinpell R., Pilon B. (2014). Quality and financial impact of adding nurse practitioners to inpatient care teams. The Journal of Nursing Administration's Annual Conference, 44, 87–96.
Kumar M., Shah S. (2015). A multistep model of resilience development. International Journal of Indian Psychology, 3. Retrieved from: http://oaji.net/articles/2015/1170-1448038605.pdf .
Levinson D. J. (1977). The mid-life transition: A period in adult psychosocial development. Psychiatry, 40, 99–112.
Lewin J., Balser J. (2017). The hidden epidemic: the moral imperative for academic health centers to address health professionals' well-being. The Blue Ridge Academic Health Group. WINTER 2017-2018 F REPORT 22.
Müller-Nordhorn J., Roll S., Willich S. (2004). Comparison of the short form (SF)-12 health status instrument with the SF-36 in patients with coronary heart disease. Heart, 90, 523–527.
Maslach C., Schaufeli W. B., Leiter M. P. (2001). Job burnout. Annual Review of Clinical Psychology, 52, 397–422.
Maslach C., Jackson S. E., Leiter M. P., Schaufeli W. B., Schwab R. L. (1986). Maslach burnout inventory (Vol. 21), pp. 3463–3464). Palo Alto, CA: Consulting Psychologists Press.
Maslach C., Leiter M. P. (2016). Understanding the burnout experience: Recent research and its implications for psychiatry. World Psychiatry, 15, 103–111.
Mealer M., Hodapp R., Conrad D., Dimidjian S., Rothbaum B. O., Moss M. (2017). Designing a resilience program for critical care nurses. Advanced Critical Care, 28, 359–365.
Moote M., Krsek C., Kleinpell R., Todd B. (2011). Physician assistant and nurse practitioner utilization in academic medical centers. American Journal of Medical Quality, 26, 452–460.
Moss M., Good V. S., Gozal D., Kleinpell R., Sessler C. N. (2016). A Critical Care Societies collaborative statement: Burnout syndrome in critical care health-care professionals. A call for action. American Journal of Respiratory and Critical Care Medicine, 194, 106–113.
Noe R. (1986) Trainees' attributes and attitudes: Neglected influences on training effectiveness. Academy of Management Review, 11, 736–749.
Pangagioti M., Geraghty K., Johnson J., Zhou A., Panagopoulu E., Esmail A (2018). Association between physician burnout and patient safety, professionalism, and patient satisfaction: A systematic review and meta-analysis. JAMA Internal Medicine, 178, 1317–1330.
Rogers A., Hwant W., Scott L., Aiken L., Dinges D. (2004). The working hours of hospital staff nurses and patient safety. Health Affairs, 23, 202–212.
Schaufeli W. B., Leiter M. P., Maslach C. (2009). Burnout: 35 years of research and practice. Career Development International, 14, 204–220.
Shanafelt T., Noseworthy J. (2017). Executive leadership and physician well-being: Nine organizational strategies to promote engagement and reduce burnout. Mayo Clinic Proceedings. Innovations, Quality & Outcomes, 92, 129–146.
Sin N. L., Lyubomirsky S. (2009). Enhancing well‐being and alleviating depressive symptoms with positive psychology interventions: A practice‐friendly meta‐analysis. Journal of Clinical Psychology, 65, 467–487.
Singh R. G. (1990). Relationship between occupational stress and social support in flight nurses. Aviation, Space, and Environmental Medicine, 61, 349–352.
Siu O. L., Cooper C. L., Phillips D. R. (2014). Intervention studies on enhancing work wellbeing, reducing burnout and improving recovery experiences among Hong Kong healthcare workers and teachers. International Journal of Stress Management, 21, 69–84.
Taylor C. R., Hepworth J. T., Buerhaus P. I., Dittus R., Speroff T. (2007). Effect of crew resource management on diabetes care and patient outcomes in an inner-city primary care clinic. Quality and Safety Health Care, 16, 244–247.
Welp A., Meier L., Manser T. (2015). Emotional exhaustion and workload predict clinician-rated and objective patient safety. Frontiers in Psychology, 5, 1573.
Welp A., Meier L.L., Manser T. (2016). The interplay between teamwork, clinician's emotional exhaustion, and clinician-rated patient safety: A longitudinal study. Critical Care , 20, 110.
Winwood P., Lusgington K. (2006). Disentangling the effects of psychological and physical work demands on sleep, recovery and maladaptive chronic stress outcomes within a large sample of Australian nurses. Journal of Advanced Nursing, 56, 679–689.
Woo B., Lee J., Tam W. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: A systematic review. Human Resources for Health, 15, 1–22.
Wright A. (2011). Communication competence approach to healthcare worker conflict, job stress, job burnout, and job satisfaction. Journal for Healthcare Quality, 33, 7–14.
Young S. N. (2007). How to increase serotonin in the human brain without drugs. Journal of Psychiatry & Neuroscience, 32, 394.